无蒂型外生性肝癌的螺旋CT诊断

©1994-2009ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.(510120)CT,,CT9CT;9,,,;CT,8,5,4;CTCT,CT;,HelicalCTdiagnosisofexophytichepatocellularcarcinomawithoutapedicleCHENXin,GUOLei,YUXia2yu,HUANGRu2hang,LIANGShuang.GuangdongprovinceTCMhospital,Guangzhou510120,ChinaAbstractObjectiveToanalyzethehelicalCTfeaturesofexophytichepatocellularcarcinoma(E2HCC)with2outapedicle,toimprovetherecognitionanddiagnosisabilityofthedisease,andtoinvestigatethediagnosticvalueofhelicalCTandmultiplanarreconstructiontechniqueinthedisease.MethodsNinecasesofE2HCCwithoutapedicleprovenbypathologicallywereincluded.ThehelicalCTfindingswithregardtothelocation,size,contour,margin,density,contrastenhancementpatternandenhancedegree,concomitancesignswereretrospectivelyreviewedbytwoex2periencedradiologists.ResultsTheE2HCCwithoutapediclewasconnectedwithliveredge,presentedalargemassex2ophytictoliver.Itscontactsurfacewiththeregionalliveredgewasnotwell2definedandshowedthebeaksign.TheCTappearanceofitwassimilartothatofprimaryhepaticcarcinoma(HCC).Eightcasesshowedfurthermorelowden2sityzoneofnecrosis.Fivecaseswererevealedthetypicalenhancementchangecharacteristicofrisingandloweringrapidlybydensity.Enhancedcircuitousvesselsweredemonstratedduringhepaticarterialphaseintumoredgeof4cas2es.CTmultiplanarreconstructioncoulddemonstratetherelationshipbetweentumorandliverpreferably.ConclusionTheE2HCCwithoutapediclehadsomeCTfeatures.Hepaticmulti2phasehelicalCTscanningandmultiplanarrecon2structiontechniquewereofgreatvalueindiagnosingE2HCCwithoutapedicle.KeywordsLivrneoplasms;Tomography,spiralcomputed(pedunculatedorexophytichepato2cellularcarcinoma,P2HCCorE2HCC),[1][2]:,,,;,,[3,4],E2HCC,()20059E2HCCCT,CT,1111:9E2HCC,,6,3,3273,5316:5,3,2,2,1:HBsAg4,(AFP)6,(30150ng/mL)4,(150ng/mL)2;5Ca2125()Ca2199,3112CT:SOMATOMSensation416CT,68mm8h,30min500800mL,200300mL,,2530s4060s180s;(3mm,9120091381ShanxiMedJ,January2009,Vol.38,No.1theFirst©1994-2009ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.)(MPR)113:9E2HCCCT,2,2211:1,8;4,3,1,1212:7,2;423cm,918cm213:5,,,4(15);,,6(,35),;,,214CT:1,8,,,1215CT:2(),,,7,,4;5,2,;,,216CT:CT,9,6,;217:4,3;1,,1,1218:95,2(TACE),2,,9,7,23311E2HCC:E2HCC,,,012%412%[5,6],,,[5,7]:;;;,E2HCC,7,[1,7];AFP,,;,,,,,E2HCC,,,[1,527]E2HCC,135,,,,Horie[8],E2HCC,(),HCC,E2HCC,312E2HCCCT:CT;CT,E2HCC,[2,4,6,9,10],E2HCCCTHCC:,,,,,,,CT,:,,,,,,:,,0220091381ShanxiMedJ,January2009,Vol.38,No.1theFirst©1994-2009ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.(),E2HCC:,,,,,[10],;,[6]E2HCC,CT,,,,E2HCC313E2HCC:E2HCC,;,,,E2HCCCT,,,,;CTE2HCC1YehCN,LeeWC,JengLB,etal.Pedunculatedhepatocellularcarcinoma:clinicopathologicstudyof18surgicallyresectedcases.WorldJSurg,2002,26:113321138.2TzouliadisL,HulinSJ,ShawI,etal.Imageofthemonth2diagno2sisanswer:pedunculatedhepatocellularcarcinoma.ArchSurg,2007,142(1):95296.3KubotaK,KitaJ,RokkakuK,etal.Ectopichepatocellularcarci2nomaarisingfrompancreas:acasereportandreviewofthelitera2ture.WorldJGastroenterol,2007,13(31):427024273.4.14CT.,2007,7(18):428924290.5HorieY,KatohS,YoshidaH,etal.Pedunculatedhepatocellularcarcinoma:reportofthreecasesandreviewofliterature.Cancer,1983,51:7462751.6KimHJ,LeeDH,LimJW,etal.Exophyticbenignandmalig2nanthepatictumors:CTimagingfeatures.KoreanJRadiol,2008,9(1):67275.7ArakawaM,KimuraY,SakataK,etal.Propensityofectopiclivertohepatocarcinogenesis:casereportsandareviewofthelit2erature.Hepatology,1999,29(1):57261.8HorieY,ShigokuA,TanakaH,etal.Prognosisforpedunculatedhepatocellularcarcinoma.Oncology,1999,57(1):23228.9,,.CT.,2007,23(4):2292230.10,.CTDSA.,2007,13(6):4482452.(:2008207229):,,19796,,,510120(044600),,,20084,1115cm;,115cm2115cm,,,3,,,115cm,1cm,,(:2008209216):,,19801,,,0446001220091381ShanxiMedJ,January2009,Vol.38,No.1theFirst